Literature DB >> 12842522

Ischemic preconditioning is not cardioprotective in senescent human myocardium.

Babett Bartling1, Ivar Friedrich, Rolf E Silber, Andreas Simm.   

Abstract

BACKGROUND: Cellular and functional changes secondary to aging could impair myocardial tolerance to ischemia and affect the heart's response to ischemic preconditioning.
METHODS: We investigated the impact of cardiac aging on preconditioning in right atrial trabeculae of adult patients (< or = 55 years) and senescent patients (> or = 70 years) with coronary artery disease. Specimens were subjected to 30 minutes of simulated ischemia (hypoxic substrate-free superfusion) with and without 5 minutes of ischemic pretreatment. Postischemic contractile recovery was measured and expressed as percentage of base line force values.
RESULTS: During the reoxygenation period, trabeculae of adult patients but not those of senescent patients improved after ischemic preconditioning. After 40 minutes of reoxygenation, preconditioned adult trabeculae developed 57% +/- 5% of their preischemic force (nonpreconditioned control 44% +/- 5%, p < 0.01), senescent trabeculae recovered to 44% +/- 4% (control 45% +/- 3%). Especially myocardium from adult patients with Canadian Cardiovascular Society (CCS) stage III angina pectoris treated with ACE inhibitors recovered well (70% +/- 7%; control 50% +/- 8%, p < 0.01), contrasting with trabeculae from patients with CCS stage II angina (44% +/- 5%; control 40% +/- 10%). Ischemia-inducible Hsp70 (human heat shock protein) was additionally measured after reoxygenation. Total Hsp70 mRNA was elevated in preconditioned myocardium along with its contractile recovery (r = 0.33, p = 0.07). Because the control transcription, analyzing 18S rRNA and beta-actin, was reduced by ischemia but recovered in preconditioned trabeculae, relative Hsp70 mRNA was not altered.
CONCLUSIONS: Our data indicate that ischemic preconditioning has no beneficial effect on the postischemic functional recovery of senescent human myocardium.

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Year:  2003        PMID: 12842522     DOI: 10.1016/s0003-4975(03)00186-3

Source DB:  PubMed          Journal:  Ann Thorac Surg        ISSN: 0003-4975            Impact factor:   4.330


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